Talk Descriptions

Wednesday, May 20th:

The Shock Course 8:00am-4:30pm

The Shock Course was designed for the rural health care practitioner. Participants will review the management of the hemodynamically unstable patient and discuss the workup and treatment of these patients. An interactive, case-based course with hands-on practice with ultrasound and central line insertion and management. This program has been accredited for 8.0 Mainpro-M1, C, and MOC Section 1 Credits.

The Neonatal Resuscitation Program (NRP) 9:00am-3:30pm

The Neonatal Resuscitation Program (NRP) has been designed to teach an evidence-based approach to the resuscitation of the newborn. The causes, prevention, and management of mild to severe neonatal asphyxia are carefully reviewed so that health professionals may develop optimal knowledge and skill in resuscitation. Accreditation to be determined.

Thursday, May 21:

The OB Ultrasound Course 9:00am-3:30pm

Learn how to use bedside ultrasound to dramatically improve management of patients in the 3rd trimester. Be able to answer these specific questions: Is the fetal presentation head down? Is fetal cardiac activity present? Is the placenta a safe distance from the cervix? Is there a normal amount of amniotic fluid? This program has been accredited for 9.0 Mainpro-M1, C, and MOC Section 1 Credits.

Friday, May 22nd Morning

8:30am-9:30am:
Plenary Session, Competence, Confidence, and Credentialing
Panel discussion addressing how to best address issues and concerns about practitioner practice, confidence, and quality.

10:00am-10:50am:New to Rural Practice Mentoring Program – UBC Rural CPD
Report by UBC RCPD on the results of the pilot for the New to Rural Practice Physician Mentoring Program.

ECG Interpretations for Nurses (Rural Nursing Stream)
A review of basic anatomy and physiology of the heart, electrical conduction system ‘pacemakers of the heart’, 12 & 15 ECG lead placement and the significance of the need for 15 lead ECG, ECG waveform and elements of a normal ECG, how to identify dysrhythmias & relevant implications and nursing interventions, including ACLS algorithms, heart blocks, MI’s and identification, and NSTEMI/STEMI Treatment.

Common Paediatric Emergency Cases
This session will discuss the assessment of the unwell child, promote recently-introduced guidelines, explore relevant investigations for the unwell child, and foster discussion between emergency staff and paediatricians.

11:00am-11:50am:Scope of practice: RN vs NP in the rural context
Participants will develop a greater understanding of the current scope of practice of Registered Nurses (RNs), Certified Practice RNs and Nurse Practitioners in BC and may apply this understanding to care delivery in rural and/or remote settings.

Clinical Coaching and the Importance of Goal Setting
Coaching is gaining a lot of interest in the medical field as an approach to CPD and life-long learning. The differences between coaching and mentoring or counseling will be discussed. The basics of coaching will be reviewed, with an emphasis on the process of goal setting and accountability.

Ambulatory Care Management of Type 2 DiabetesThis session will include the use of guidelines as well as newer oral and injectable medications for the ambulatory management of Type 2 Diabetes

Practical Tips for Managing the Complications of Liver Cirrhosis
Learning objectives:
1) Understand the basic pathophysiology of cirrhosis and portal hypertension,
2) Recognize the classic presentations of decompensated liver disease and complications of portal hypertension, and
3) Have a basic understanding of how to manage the complications of cirrhosis and portal hypertension.

Non-operative Management of AppendicitisDescription to come

10:00-11:50 (workshops):The Difficult Intubation in a Rural ERThis workshop includes a lecture as well as hands on skills practice. Topics covered in the lecture include: indicators of a potentially difficult adult intubation; preparation, including medications, for adult intubation; and, management of difficult airway situations. Hands-on skills practiced include: direct laryngoscopy and intubation, with an emphasis on preparation; use of a Glidescope and bougie; brief discussion of supraglottic airways

Evaluation and Treatment Strategy Based on Emergency Bedside Ultrasound FindingsIn this workshop, participants will use the RUSH protocol o understand how bedside ultrasound can: assist in finding the causes of hypotension, assist in the management/treatment of hypotension. Participants will have hands-on experience in bedside scanning of live models for cardiac, IVC, and lung examinations.

Gynecological Procedures in the Office
To describe and have a limited hands on experience on the following: insertion and removal of IUDs, paracervical block, endometrial biopsies, removal of cervical polyp, vulvar biopsies, treatment of genital warts.

Practice Improvement using Data and QI — What’s Being Done and the Changing Landscape in BC (Mentorship)
Learning objectives: After providing an overview of the BC landscape, the following discussions will take place:
– The ‘mechanics’ of data use (as its evolving in BC)
– Examples of how data is being used to improve practice in BC
– The importance of data and the evolving landscape

SIPS, NIPT, NT, U/S – WTH? 1st Trimester Questions and how to answer them – even if you don’t do OB
Lecture discussing common rural first trimester obstetric issues and how to address them in a general practice setting.

Endocrinology Emergencies in Rural and Remote SettingsTopics covered will include diabetic ketoacidosis, and Addisonian crisis leading to acute adrenal failure

Cardiogenic Shock – A Case Presentation
Reviewing the management of cardiogenic shock through a case based presentation, the findings/consequences of severe mitral regurgitation, and the causes and lab findings of severe lactic acidodis.

3:00pm-3:50pm:

Osteoarthritis, Exercise, and ObesityDiagnosis and Treatment of Osteoarthrits. Evidence-based approach to the most common MSK diagnosis.

PPH, SNS, APNC, PPD – WTH? Postpartum Presentations and how to begin to address them – even if you don’t do OB
Lecture discussing common rural post-partum presentations and how to address them in a general practice setting

50 Shades of Grey: Infectious DiseasesParticipants will learn to recognize emerging issues in infectious diseases both locally and internationally, screen patients for emerging infectious diseases in BC, and be able to implement treatment plans for emerging infections.

Airway and Procedural Sedation
1. Procedural sedation: how to evaluate and monitor patients, which drugs to use and how, safety checklists, post procedure care.
2. Noninvasive positive pressure ventilation: BiPAP, CPAP and some “new kids on the block” such as Optiflow
3. Delayed Sequence Intubation (DSI)
Describing the principles of this helpful technique for patients who have altered mental status, preventing adequate preoxygention prior to intubation.

C-spine X-ray InterpretationDescription to come

Advanced Bedside Ultrasonography for the Emergency PhysicianLearning objectives for this session include:
1) enhanced approach to the FAST examination,
2) bedside ultrasound to identify DVT in the legs, and
3) RUQ ultrasound for gallbladder disease.

Nurses’ Basic Suturing and Wound Closure (Rural Nursing stream)
This session will meet the following learning objectives: 1) goals of wound closure; 2) wound assessment and evaluation; 3) principles of wound healing. Clinical pearls and skills development will be used to help participants achieve their learning objectives.

4:20pm-5:20pm:
Plenary: Narcotics, Alcohol, and Addictions panel
Panel discussion about diagnosing and treating patients struggling with narcotic, alcohol, and other addictions in a rural setting.

Office Screening, Diagnosis, and Management of Youth Anxiety Disorders and Depression
Delegates will be taught to: 1) recognize the prevalence of youth anxiety disorders, depression and ADHD, 2) easily screen for these conditions in our offices, 3) learn efficient diagnostic tools for anxiety and depression, 4) learn practical treatment and monitoring tools for anxiety, depression, substance use and suicide risk; and 5) recognize the community treatment team with Child and Youth Mental Health and School Counsellors.

Thyroid Nodules: They Don’t Have to Be a Pain in the NeckDescription to come

Soft Tissue Issues (Jim Ongena)
Common soft tissue injuries that occur in wilderness settings will be covered when there is only a small first-aid kit available. Cuts, bruises, and sprains will be the main focus. Topics will include: the first 4 minutes, cleaning the wound (infection considerations), options for closing the wound, managing travel back to the road, to follow-up or not?

RACE-y Pictures: Dermatology on the Phone (co-presented with Neil Kitson)
Understanding how new technologies can support virtual dermatology services in rural and remote BC.

Practical Deprescribing: Level 1 Introduction
Too many people are taking too many prescription drugs, often causing more harm than benefit. This session will help participants to be able to 1) rank a patient’s medication list quickly by priority (probably useful/irrelevant/probably harmful), 2) recognize likely drug interactions and develop a plan to eliminate potentially dangerous interactions (kinetic or dynamic), 3) use elimination half-lives of drugs to plan safe deprescribing, and 4) gain confidence in challenging unsupported, impractical, or potentially dangerous prescriptions originated by specialists.

Extensor Tendon Repair and a Simple Flap (1 hour workshop, offered twice)
Participants will learn how to repair an extensor tendon, and how to suture a simple flap.

Advanced Bedside Ultrasonography for the Emergency PhysicianLearning objectives for this session include:
1) enhanced approach to the FAST examination,
2) bedside ultrasound to identify DVT in the legs, and
3) RUQ ultrasound for gallbladder disease.

Trauma Airway Pearls
This session will cover strategies to optimize oxygenation and intubating conditions, prevent desaturation, and will feature a discussion of intubation algorithms during shock/trauma.

Saturday, May 23th Afternoon Sessions

1:00pm-1:50pm: Plenary Patient Transportation discussion panel

2:00pm-2:50pm:The Black, The Blue, and the UglyThis session will address common varieties of skin cancer, including epidemiology and presentation in a case based format. An update on the management of common skin cancers will also be discussed.

Some Aspects of Emergency Psychiatry
The presentation will review the causes of behavioural dyscontrol in the Emergency Room, differences between delirium and psychosis, and the pharmacological and non-pharmacological approaches to managing agitation, aggression and violence in the ER, and appropriate use of the Mental Health Act in the ER.

Office Management of Sports-Related Concussion
Learning objectives for this session include: 1) how to prepare for the concussion patient; 2) what treatment advice really works initially? 3) what’s new with rest advice? 4) Return to Learn protocol? 5) Return to Play protocol? 6) who to refer and when/why? 7) who to retire? and 8) is CTE really such a big deal?

Second and Third Trimester EmergenciesDescription to come

Hypothermia (co presented with Linda Johannson)This session will discuss the new guidelines for management of hypothermia.

3:00pm-3:50pm:Practical Deprescribing: Level 2 AdvancedThis small group workshop will allow physicians interested in learning how to work with patients and specialists in deprescribing medications (Part 2 of the 10:00 am Practical Deprescribing: Level 1 workshop)

High Altitude MedicineDescription to come

Building Your Research Idea into a Research ProjectWorkshop participants will learn how to develop their research idea into a fully realized research project.

Hurry Up and Wait: The New Oral Anticoagulants / BP and LDL TargetsThis session will
1) summarize the randomized controlled trial evidence for dabigatran, rivaroxaban, and apixaban in patients with non-valvular atrial fibrillation,
2) summarize the key critical appraisal issues related to the randomized controlled trials for the aforementioned drugs,
3) compare the evidence for the aforementioned drugs with warfarin for this indication,
4) describe the study methodology required to test therapeutic targets,
5) summarize why LDL targets for the prevention of cardiovascular disease are not justified based on evidence, and
6) summarize the evidence for BP targets in hypertension with or without other conditions (e.g. Type II DM).

Obesity in PregnancyDescription to come

Dealing with the Aftermath: Recognizing and Managing PTSD in Your Patients
In this session, participants will learn to 1) recognize the varied presentations of PTSD in your practice, 2) discuss the management of traumatic events that leave lasting psychological problems, 3) recognize the impact on quality of life and relationships, and 4) discuss the difficulties in dealing with “memories”.

2:00pm-3:50pm (workshops):Introduction to Beside UltrasoundThis workshop will be ideal for the practitioner with little or no ultrasound experience.

The Airway From Hell: Toys and Tricks from a Non-anaesthetistDescription to come

Rural Critical Core Module – Chest Tubes, Seldinger Technique
Participants will learn current indications for closed chest drainage, the use of small diameter and Seldinger technique tubes in closed chest drainage. Participants will also have the opportunity to practice the techniques of Seldinger technique chest tube insertion in a hands-on, practical fashion.

4:20pm-5:20pm: Plenary Wilderness Medicine Around the World
An inspiring discussion of how wilderness medicine is practiced in various jurisdictions around the globe.

Sunday, May 24th Post-Course

The Wilderness Medicine Course 8:00am-4:30pm

This course is back after a wildly successful and highly acclaimed introduction last year. It will appeal to those who would like to explore
self-directed, austere environment emergency medicine. Ideal training for physicians who enjoy outdoor recreation or are interested in
working in Search and Rescue. There will be a strong focus on hands-on skills and high-fidelity simulations in the field. Upon completion,
practitioners will have improved knowledge and skills to enable them to provide good medical care in a wilderness environment.
Course is accredited for 7.0 Mainpro-M1 and MOC Section 1 Credits.